Organization
CHARLES J PORTALES DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J PORTALES DDS (OWNER)
(936) 441-3363
Entity
Organization
Contact information
Practice address
2101 MAUREL, CONROE, TX 77304-1231
(936) 441-3363
(936) 494-2189
Mailing address
2101 MAUREL, CONROE, TX 77304-1231
(936) 441-3363
(936) 494-2189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19018
TX
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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